A quick look at one HIE evolving with API-based infrastructure

John Hopkins Medicine is among the providers in the HIE provider network. Credit: Facebook

In recent years, state and regional health information exchanges – the ones that have managed to survive the depletion of federal HITECH incentive dollars, at least – have been forced to adapt to a changing landscape by enlisting new partners, shifting their focus, offering value-add service and, sometimes, fundamentally rethinking their technological infrastructure.

The job of an HIE, after all, is to serve its payer and provider members by delivering data they need to enable better care within their own organizations and better health across region-wide populations.

There's no shortage of different approaches to making that work and, as a recent case study from vendor Leap Orbit shows, some of them more advanced than others.

"The most basic HIEs at least offer a Direct secure messaging service and a clinical record portal. A large number also offer encounter alerts, public health registry reporting, quality reporting support, and some form of reporting or analytics. The more evolved HIEs are also offering complex services to support prescription drug monitoring, population health, predictive risk modeling, and a score of other detailed use cases,” the case study found. “Most importantly, these organizations are also thinking about how to make their data more usable, visible, and available to wider audiences and stakeholder groups."

One example is Columbia, Maryland-based CRISP – it stands for Chesapeake Regional Information System for our Patients – a regional HIE serving Maryland, West Virginia and Washington, D.C. With help from Leap Orbit, it recently transitioned, over several years, to an API-based infrastructure.

The shift has enabled the HIE, which supports providers at Johns Hopkins Medicine, MedStar Health, Adventist Healthcare and others, to more easily transmit data for "a host of new innovative use cases," according to the vendor.

These include in-context alerts, which enable delivery of prescription drug monitoring program data, overdose alerts, public health alerts, provider and care management attribution and more, directly into electronic health record workflow.

"Critical information from the CRISP HIE is now being directly embedded into the EHRs of thirty-seven out of the forty-seven hospitals across the state of Maryland, with the last ten still under development," according to the report. (Healthcare IT News has previously reported on Leap Orbit's RxOrbit technology, which delivers PDMP directly into clinical workflows.)

Another use case is the CCDA Federator, which compiles clinical documents from a range of sources including other members of the HIE and also from national networks such as Carequality. Discrete data APIs, meanwhile, enables providers to query the HIE for specific data such as medications and attribution.

"The evolution to API-based interoperability has so far been a win for all of CRISP’s stakeholders," according to Leap Orbit. "Physicians are receiving vital information to help better inform decision-making at the point of care. Patients are receiving better care with the hope of it ultimately improving their overall health status. The state is realizing Medicare cost-savings with targeted information fostering more efficient coordination of resources."

Even better, unlike many struggling state and regional HIEs across the country, CRISP is "now experiencing an exponential increase in utilization volume." With APIs enabling easy integration of data into physicians' EHR workflows, the doctors are "increasingly realizing the value and becoming reliant on this data on a daily basis."